Publication details

Unicuspid Aortic Valve in Patients Undergoing the Ross Procedure

Authors	GOFUS Jan FILA Petr VOBORNIK Martin ONDRASEK Jiri NĚMEC Petr ŠTĚRBA Jan CERMAKOVA Eva TUNA Martin VOJACEK Jan
Year of publication	2023
Type	Article in Periodical
Magazine / Source	Annals of Thoracic Surgery
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://www.sciencedirect.com/science/article/abs/pii/S0003497522005124?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.athoracsur.2022.03.061
Keywords	Unicuspid Aortic Valve; Ross Procedure
Description	BACKGROUND The prevalence and outcomes of the unicuspid aortic valve (UAV) in patients undergoing the Ross procedure have been strongly underreported in the current literature. We sought to evaluate this in comparison with bicuspid (BAV) and tricuspid valve (TAV) in our Ross cohort.METHODS This was a retrospective observational study of patients undergoing the Ross procedure at 2 dedicated centers between 2009 and 2020. Primary end points were the risks of midterm autograft reoperation and the onset of at least moderate aortic regurgitation during follow-up. The secondary end point was to compare the perioperative out-comes between the groups.RESULTS Included in the analysis were 286 patients, of those 39% with UAV, 52% with BAV, and 9% with TAV. UAV patients were operated on at the youngest age (P < .001) and more often for a combined hemodynamic aortic valve pathology (P = .02). They had the largest aortic root dimensions: annulus (P = .01), Valsalva sinuses (P = .11), sino-tubular junction (P = .001), and ascending aorta (P < .0001). The risks of reoperation (P = .86) and the onset of aortic regurgitation (P = .75) were comparable among the groups over the follow-up of 4.1 years. There was no difference in perioperative outcomes.CONCLUSIONS UAV is a separate unit characterized by a distinct hemodynamic pathology and generated aortopathy. It is not associated with a higher risk of reoperation or new onset of aortic regurgitation after the Ross procedure in the midterm postoperatively. At the current state, UAV remains acceptable for the Ross procedure.